糖尿病非肥胖人群腰围与新发非酒精性脂肪肝的关系

摘要

目的：探讨糖尿病非肥胖人群腰围增加与新发非酒精性脂肪肝之间的关系。方法采用前瞻性队列研究方法，选取空腹血糖≥7.0 mmoL/L或<7.0 mmoL/L但既往已被确诊为糖尿病并使用降糖药物且体质指数（BMI）<25 kg/m2者1950例，依据基线腰围分为5组，腰围＜78 cm为A组（387例）；78 cm≤腰围＜82 cm为B组（377例）；82 cm≤腰围＜85 cm为C组（307例）；85 cm≤腰围＜90 cm为D组（458例）；腰围≥90 cm为E组（421例）。应用多重Logistic回归模型分析影响糖尿病非肥胖人群新发脂肪肝的影响因素。结果观察队列的平均随访时间为（47.24±5.13)个月，至2010年度查体时，非酒精性脂肪肝的发病率为11.85%（231/1950），A、B、C、D、E组发病率依次为6.98%、9.28%、12.38%、14.19%、15.68%，其随腰围水平的增加而依次升高（P＜0.05）。在多重Logistic回归模型分析中，与A组比较，总人群D、E组的OR值分别为1.97、2.19（P＜0.05）。结论糖尿病非肥胖人群腰围≥85 cm是新发非酒精性脂肪肝的危险因素。%Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re⁃sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re⁃gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.